One enters Palo through an initiation known as rayamiento ("scratching"), in which the body is marked and the initiate is bound to the house, its spirits and its ranked hierarchy of tata and yaya (father and mother of the religion). Ritual life centres on the nganga and on gatherings marked by drumming, song in a Kikongo-influenced ritual language, and possession by the dead.
Many practitioners are also initiated in Santeria and regard the two systems as complementary rather than competing, a Cuban pattern in which Palo handles certain kinds of work and the oricha religion others; both have long coexisted with popular Catholicism. Following the Cuban migrations of the twentieth century, Palo established communities in the United States, especially Florida, New York and New Jersey, and elsewhere in Latin America, and it continues to be practised in Cuba itself.
Scholars treat it as one of the major Afro-Cuban religions, alongside Santeria (Regla de Ocha) and the Abakua society, and as an important surviving expression of Kongo religious thought in the Americas. Reliable membership figures do not exist, both because of the tradition's secrecy and because affiliation is defined by initiation into particular houses rather than by any central body.